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Should I take Tamiflu to treat the flu?

Consumer Reports News: January 23, 2013 10:23 AM

Not unless you're very sick with the flu or you're sick from it and vulnerable to complications because you're hospitalized, pregnant, 65 or older, have asthma, or are otherwise at high risk. "Tamiflu is a tricky topic. People have an unrealistic idea about what this drug can do," says Beverly Schaefer, RPh, pharmacist and co-owner of Katterman's Sand Point Pharmacy in Seattle.

Tamiflu (oseltamivir) and another prescription drug called Relenza (zanamivir) are approved by the Food and Drug Administration to treat the flu. Unlike flu drugs you can buy without a prescription, Tamiflu and Relenza don't just treat flu symptoms but can shorten how long you have the illness, by inhibiting the growth of the virus. And they can reduce the risk of complications such as pneumonia and respiratory failure, if you take them within 48 hours of the onset of symptoms. But the drugs aren't recommended for mild cases, for several reasons.

First, Tamiflu can cause side effects such as headache, nausea and vomiting. There have also been reports of delirium and other psychiatric events, particularly in children. Relenza can cause cough, as well as nasal and throat discomfort, and shouldn't be taken by anyone with asthma or chronic obstructive pulmonary disease (COPD).

What's more, taking antivirals if you don't need them may breed drug-resistant strains of the virus, just as the overuse of antibiotics leads to antibiotic-resistant bacteria. And it can reduce the supply of drugs for people who need them the most. In fact, the FDA has already reported shortages of the oral suspension form of Tamiflu, in some areas.

Also, you should know that Tamiflu is expensive. A 5-day course of the drug will cost at least $100.

For those reasons, the Centers for Disease Control and Prevention says that only certain groups should take antivirals, including:

people sick enough to be hospitalized with the flu

those with a severe, complicated, or progressive health problem such as chronic pulmonary disease, including asthma, metabolic disorders such as diabetes, heart disease or a suppressed immune system

children younger than 2

adults 65 or older

pregnant women

people younger than 19 who on long-term aspirin therapy

American Indians or Alaska Natives

those who are morbidly obese (a body-mass index of 40 or higher)

residents of nursing homes and assisted-care facilities

In addition, because antivirals might make you less likely to spread the flu, you could consider taking the drugs if you have the illness and you care for someone who has a compromised immune system, respiratory disease, or heart failure.

"For most adults without complicating health concerns, treating flu symptoms with rest, fluids, aspirin, acetaminophen or ibuprofen is their best course of action," advises Schaefer. "Rest is a key factor. Stay home and sleep all day. Give your body a chance to recoup. Lots of fluids. Don't contaminate others."